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Inflammatory Diseases of The Esophagus

Inflammatory diseases of the esophagus

Esophagitis – Elite Treatment in Europe

Gastroenterology -2005

Inflammatory diseases of the esophagus called esophagitis.

Esophagitis – an inflammation of the esophageal wall, most of its inner lining, called the mucosa.

Predisposing factors for the development of esophagitis are eating too hot food, accidental or intentional use of chemically active substances – alkalis, acids, etc. Inflammatory diseases of the esophagus develops when there is insufficient usage of vitamins, diseases, leading to oxygen starvation of tissues.

To cause gastric esophagitis with increased aggressiveness of the gastric juice, disruption of the lower esophageal sphincter, when the stomach contents into the esophagus can penetrate and damage to the wall. Sometimes the inflammatory lesion of the esophagus occurs when the injury of its walls, if used dry solid food. The immediate cause of inflammation of the esophagus wall are infectious diseases.

Esophagitis can be focal, if affected a small section of the esophagus or diffuse, when the inflammation extends to the entire esophagus.

Separately identify reflux esophagitis. This inflammatory process in the lower esophagus, which is adjacent to the lower esophageal sphincter (the cardia). This type of inflammation of the esophagus caused by insufficient clamping cardia, because of what is part of the stomach contents reflux into the esophagus – gastroesophageal reflux. Reflux occurs when the weak closure of the lower esophageal sphincter. If there is a delay in gastric emptying, there is increased pressure. Under increased pressure a weak lower esophageal sphincter is stretched across a hole in it the contents of the stomach gets into the esophagus.

Reflux esophagitis is most common in the hiatal hernia, where part of the stomach, sometimes with the lower end of the esophagus falls into the chest cavity through the muscular diaphragm ring. In gastric ulcer breaks its normal locomotor activity (motility), and the contents of the stomach becomes more aggressive. Stenosis of the orifice of the stomach into the duodenum (the pylorus), gastric emptying is slowed down, pressure is increasing and this also leads to the penetration of stomach contents into the esophagus. The same mechanism occurs, and cholecystitis, which is accompanied by a violation of the motor and secretory functions of the stomach.

To reflux esophagitis can cause consequences of surgical interventions on the stomach and esophagus. Sometimes the cause of reflux esophagitis are tumors of the abdominal cavity, liver disease (cirrhosis). Normally, the stomach can not get into the esophagus, since the opening of the esophagus to the stomach is closed due to contraction of the smooth muscles of the lower esophageal sphincter, even though the pressure in the esophagus is lower than the pressure in the stomach. By disruption of the sphincter muscles can cause obesity, frequent patient's stay in a tilted position with the torso, when the stomach is higher than the esophagus, with an increase in the acidity of gastric contents. Relaxation of the muscles of the lower esophageal sphincter contribute to sleeping pills and sedatives, dopamine, opioid analgesics, nitrates, aminophylline, beta-blockers. This also contributes to alcohol and, to some degree, smoking.

When reflux esophagitis patients worried about heartburn, burning sensation behind the breastbone. Burning increases in the supine position, during exercise, with overeating, torso. Often there are belching, and even stomach contents reflux into the oral cavity, especially after eating. The contents of the stomach is sour or bitter taste. This is accompanied by bad breath. Somewhat later, there are pain behind the breastbone. This pain may spread to the entire chest, heart area. Sometimes there are complaints of persistent hiccups, sore throat, hoarseness, sensation of a lump in my throat. Most patients reported excessive salivation at night.

By the nature of the defeat of the walls of the esophagus are distinguished esophagitis

catarrhal

edematous

erosive

pseudomembranous

hemorrhagic

exfoliative

necrotic

abscess.

Catarrhal esophagitis occur easily. The inflammatory process affects only the mucosa. With erosive esophagitis on esophageal mucosa are formed first minor erosion, then they merge into larger ones. This is accompanied by severe esophagitis pain and bleeding esophageal wall. As seen belching from the bloody contents, bloody vomiting, darkening of the stool (melena). Especially dangerous is bleeding from the esophagus, which can sometimes lead to great loss of blood and death of the patient.

In exfoliative esophagitis in the esophageal wall are formed film. After the rejection of the films under them exposed sores. The patient is concerned about severe pain. Sometimes ulcers can occur from bleeding.

Phlegmonous esophagitis usually takes seriously. The inflammation extends to the entire thickness of the wall of the esophagus and is accompanied by intoxication, fever, severe pain, drooling.

Necrotizing esophagitis occurs as hard, is characterized by necrosis of the esophageal wall and the spread of inflammation to the surrounding organs and tissues of the esophagus.

Treatment of esophagitis. First of all, try to eliminate the underlying disease that led to the development of esophagitis. Appointed to the use of a liquid diet, pureed food chilled for maximum schazheniya wall of the esophagus. They are used antacids, drugs that reduce the motility of the esophagus, slizezameniteli, kislotoblokatory. If necessary, appointed by the antibiotics. Used physiotherapy.